OBJECTIVE: To explore patients' perceptions of an intensive care unit diary written by relatives including pictures added by staff.

DESIGN: Ten patients were interviewed 3-6 and 8-16 months after discharge from the intensive care unit. Most patients were interviewed with a relative present. Interviews were analysed using Ricoeur's theory of interpretation.

SETTING: Interviews took place in participants' homes.

FINDINGS: Patients found the diary written by relatives with photos taken by staff to be valuable providing information that helped them understand their time in the intensive care unit. The diary text gave patients insight into relatives' experiences and suffering. Patients were touched by the love and care conveyed in the diary, however, the diaries could overwhelm the patients when they were confronted with the grief and agony endured by their relatives.

CONCLUSION: Although diaries kept by relatives confront patients with consequences beyond their own suffering, they are informative and promote understanding of what patient and family experienced during critical illness. The diaries expressed how much the relatives cared for the patient thus paving the way for mutual support and understanding. Diaries authored by relatives represent a new element to ICU diaries that have evolved from a nursing intervention toward family participation.